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Bacteremia with otitis media.

S A Schutzman1, S Petrycki, G R Fleisher

  • 1Department of Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.

Pediatrics
|January 1, 1991
PubMed
Summary
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Approximately 3% of young children with fever and otitis media have bacteremia. Higher temperatures and younger age increase bacteremia risk, but most children recover well, necessitating careful consideration of blood cultures.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Otitis media is a common childhood infection.
  • Bacteremia can be a serious complication of febrile illnesses in children.
  • Understanding the incidence and outcomes of bacteremia in children with otitis media is crucial for clinical management.

Purpose of the Study:

  • To determine the occurrence and outcomes of bacteremia in young children diagnosed with otitis media.
  • To identify risk factors associated with bacteremia in this population.
  • To inform clinical decision-making regarding the use of blood cultures.

Main Methods:

  • Retrospective chart review of 2982 patients aged 3 to 36 months with isolated clinical otitis media and fever (≥39°C).
  • Analysis of blood culture results from 1666 patients.

Related Experiment Videos

  • Correlation of bacteremia incidence with patient age and temperature.

    • Main Results:

    • Bacteremia was identified in 3.0% (50/1666) of patients.
    • Streptococcus pneumoniae was the most common pathogen (39 cases).
    • Bacteremia incidence increased with higher temperatures (1.9% at ≤40°C vs. 5.0% at >40°C) and was higher in younger children (3.7% in ≤12 months).
    • Complications observed in bacteremic patients included persistent fever, persistent bacteremia, pneumonia, and meningitis.
    • Overall, most febrile children with otitis media recovered well.

    Conclusions:

    • Approximately 3% of young febrile children with otitis media present with bacteremia.
    • Higher body temperature is associated with an increased incidence of bacteremia.
    • While bacteremia can occur, most children with febrile otitis media have favorable outcomes.
    • Clinicians should weigh the benefits of blood cultures against costs and patient discomfort.